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DR. BRADLY KALB RUSSELL DDS
NPI 1932490307
Dentist - Oral and Maxillofacial Surgery in Winston Salem, NC

Active since April 20, 2011PECOS Enrolled
1601 S HAWTHORNE RD, WINSTON SALEM, NC 27103(336) 765-9550(336) 765-9552 Get Directions Write a Review

NPPES record last updated: October 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 6, 2021, Jun 27, 2018 (2 updates tracked since 2018).

About Dr. Bradly Kalb Russell Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRADLY KALB RUSSELL DDS (NPI 1932490307) is an individual oral and maxillofacial surgery provider in Winston Salem, North Carolina, licensed in Ohio (30.0239911) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932490307
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BRADLY KALB RUSSELLCredential: DDS
Location Address1601 S HAWTHORNE RDWinston Salem, NC 27103-4127
Mailing Address1601 S Hawthorne RdWinston Salem, NC 27103-4127 · (336) 765-9550 · Fax (336) 765-9552
Phone(336) 765-9550
Fax(336) 765-9552
Sole ProprietorYes
Enumeration DateApril 20, 2011
Last NPPES UpdateOctober 6, 20212 updates tracked since enumeration
NPPES CertifiedOctober 6, 2021
✔ NPI 1932490307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in OH · 30.0239911✔ Licensed in NC · 11536✔ Licensed in OH · 30-023991
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1601 S HAWTHORNE RD, Winston Salem, NC 27103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bradly Kalb Russell Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SMITH & RUSSELL DDS PLLC
Dentist (Oral and Maxillofacial Surgery)
1601 S HAWTHORNE RD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-9550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradly Russell's NPI number?

The NPI number for Bradly Russell is 1932490307. It was assigned to this individual provider in the NPPES registry on April 20, 2011.

Where is Bradly Russell located?

Bradly Russell practices at 1601 S Hawthorne Rd, Winston Salem, NC 27103. The listed phone number is (336) 765-9550.

What is Bradly Russell's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Bradly Russell enrolled in Medicare?

Yes. Bradly Russell is registered in the Medicare PECOS enrollment system.

What insurance does Bradly Russell accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and MedMutual list Bradly Russell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bradly Russell was last updated on October 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.